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3 <br /> Attachment 1 <br /> Sewer Utility Dedication Form <br /> City of Mebane <br /> City of Mebane <br /> 106 E. Washington St. <br /> Mebane, NC 27302 <br /> Re: Efland Sewer System, known to the North Carolina Department of Environmental <br /> Quality as the Efland-Cheek Collection System, Permit No. WQCS00194 <br /> Subject: Transfer of Ownership to City of Mebane <br /> Orange County, North Carolina, the current owner of the subject public sanitary sewer <br /> collection system, does hereby dedicate and convey unto the City of Mebane, its <br /> successors and assigns, all of its rights, title, easements and interest in and to the <br /> sewer lines, pump stations and appurtenances, constructed in accordance with various <br /> plans over the years as summarized on Attachment 2 and more particularly delineated <br /> on map Attachments 3.1 through 3.4. <br /> IN WITNESS WHEREOF, this letter is executed by the duly authorized officers of <br /> Orange County, North Carolina and its corporate seal to be hereunto affixed, on the <br /> day, month of in the year 2018. <br /> ATTEST: BY: <br /> Donna S. Baker <br /> Clerk to the Board, Orange County Chair, Orange County <br /> Board of County Commissioners Board of County Commissioners <br /> NORTH CAROLINA <br /> ORANGE COUNTY <br /> I, a Notary Public, hereby certify that <br /> personally appeared before me this day and <br /> acknowledged that she is the Clerk to the Board of County Commissioners for Orange <br /> County, NC, a government entity, and that by authority duly given as the act of the <br /> Board of County Commissioners, the foregoing instrument was signed in its name by its <br /> Chair, sealed with its corporate seal, and attested as its Clerk. <br /> Signature of Notary Public <br /> My Commission Expires: <br />